A few months have passed since health officials declared a meningitis outbreak at Rutgers University following the diagnosis of the potentially deadly meningococcal disease in two undergraduate students on the New Brunswick campus.
The university remains on alert for the disease, however. And recommendations developed by it, with input from local health officials, the state Department of Health (DOH) and the federal Centers for Disease Control and Prevention (CDC), apply to all undergraduate students — residential, off-campus and commuters. (The students who contracted the disease in New Brunswick were diagnosed in March and April; they were treated and have since recovered.)
On Thursday, Rutgers office of Student Health posted an updated memo on its website, reminding all incoming and returning students that they must receive the first two of a three-dose vaccine before showing up in September. The shots are available at doctors’ offices and at many drugstores. Students must bring proof of their inoculations when they return to school.
Without proper treatment, meningococcal meningitis, a rare but serious inflammation of the spinal cord and brain lining, can lead to death within 48 hours. It is caused by various bacteria, and can be spread through saliva — by kissing, sharing eating utensils or water bottles, or by coughing and sneezing in proximity with others. Not everyone who has the disease shows symptoms, but they can still transmit it to others.
For these reasons, infectious disease experts recommend preventative meningitis vaccines for college students living on campus, soldiers in barracks, and others living in close quarters. According to the Immunization Action Coalition, New Jersey is one of three dozen states that require college students be inoculated against the disease; it is one of 28 states that mandate vaccines for schoolchildren (starting in Grade 6 in New Jersey).
These mandates focus on a single vaccine that guards against the four most common strains of bacteria that can cause meningitis, types A, C, W and Y. The Rutgers outbreak involved a different bacterium, type B, that can’t be blocked by the same immunization. For that reason, Rutgers officials require incoming and returning students to get the first two out of three shots of the MenB vaccine, in addition to the traditional MenACWY course already required by state law.
“It’s an ongoing issue,” explained Larry Downs, CEO of the Medical Society of New Jersey, “not something new like Ebola or Sars or some kind of emerging new flu strain” that doctors are unfamiliar with treating. “But the risk is there for people living in close proximity.”
So far this year there have been 21 cases nationwide, with four in this region, counting those in New Brunswick. This is according to HealthMap.org, which tracks outbreaks worldwide. Eight of the cases were fatal. Another eight — including the Rutgers incidents — occurred on college campuses.
The Rutgers outbreak involved a different strain than the one that infected students at Princeton University in 2013 and 2014 — although both were prompted by a type B bacterium. The Princeton outbreak led to diagnoses in seven students and one visitor, a Drexel University student who later died.
According to the DOH —other than in reaction to a campus or other site-specific outbreak — experts typically recommend the MenB vaccine only for certain individuals with specific risk factors, including sickle cell disease, certain blood deficiencies, or for microbiologists who work with the bacteria.
The state maintains a website on the disease with a page on the Rutgers cases, information for the public, and updates for physicians.
The CDC – which lists the Rutgers outbreak on its website – gives the symptoms of meningitis as fever, headache, stiff neck, nausea, vomiting, confusion, and light sensitivity; they can come on suddenly. One in ten people diagnosed will die; one in five survivors will end up with a permanent disability.